- 期刊
Myositis Ossificans Mimicking Soft Tissue Neoplasm
類似軟組織腫瘤之骨化性肌炎
摘要
骨化性肌炎是骨頭異位性形成的一個良性情況。這是一種臨床上較不常見的疾病，所以診斷並不容易。這裡我們提出一個創傷後引起的骨化性肌炎病例：一位六十五歲男性，在一次中國功夫訓練的練習之後，左上臂的前方突然形成了一個腫大且有疼痛感的腫塊。我們安排病人接受放射線影像檢查、超音波檢查以及磁振造影檢查以查明病因，但仍無法完全確定是骨化性肌炎或是惡性腫瘤。我們建議患者接受試探性手術以查明病因，手術後的病理檢查確診為骨化性肌炎 。由於腫塊在藥物及復健治療之後慢慢復原縮小，所以沒有做進一步的切除手術。兩個月後，病人完全痊癒。簡而言之，要提早診斷出非典型或早期的骨化性肌炎，若病患呈現出創傷後伴隨著肢體有不正常的疼痛性腫塊，不論影像學檢查是否有無明顯異位鈣化的情形，臨床醫師及放射科醫師都要將此診斷列入高度考量。因此若臨床上有懷疑是骨化性肌炎的病例，連續的放射線造影檢查以及超音波檢查將是簡單又值得注意的方法。
並列摘要
Myositis ossificans is a benign condition of heterotopic bone formation. It is a relatively uncommon disease, and differential diagnosis can be difficult because many findings are typical but not pathognomic. We report a patient with early myositis ossificans traumatica, which was not diagnosed until a surgical specimen was obtained. This 65-year-old man presented with a swollen painful lump over his left anterior arm after a session of Kung Fu training. Imaging findings were equivocal and a neoplastic process could be excluded. Exploratory surgery was performed to ascertain the nature of the lesion and pathology revealed pathognomonic features of myositis ossificans. The lump resolved with medical treatment several weeks later. Prompt diagnosis of atypical or early myositis ossificans requires that radiologists maintain a high index of suspicion when a patient presents with a post-traumatic lump, even when radiographic findings are equivocal or negative. A watchful-waiting approach with serial plain radiography and ultrasonography may avoid unnecessary surgical procedures in these cases.